生物源性材料在女性盆底重建中的作用  

Role of biomaterials in female pelvic reconstruction

作　　者：杨翔[1] 童晓文[1] 李怀芳[1] 

机构地区：[1]同济大学附属同济医院妇产科,上海市200065

出　　处：《中国组织工程研究与临床康复》2011年第29期5475-5478,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:生物源性材料用于盆底重建手术有望克服合成补片的近期及中远期并发症。异种生物植入材料因其材料来源广泛,已成为女性盆底重建领域材料学的研究热点。目的:总结近年来生物补片在女性盆底重建领域的基础及临床研究现状,对不同属性的生物植入材料的临床疗效及并发症情况进行综述。方法:应用计算机检索CNKI和PubMed数据库中2000-01/2010-08关于女性盆底重建中生物源性材料的文章。在标题和摘要中以"xenograft:surgical mesh:biomaterial:prolapse:stress urinary incontinence"或"生物材料;盆底重建;子宫脱垂;压力性尿失禁"为检索词进行检索。结果与结论:初检得到177篇文献,对符合条件的35篇文献进行汇总分析发现,生物补片的组织学反应主要由其化学交联结构和孔隙率决定。因生物补片自身属性、手术方式、入组标准及随访标准差异,临床疗效及并发症研究报道结果均存在显著差异。患者年龄和既往盆底手术史是影响手术重建成功率的主要因素。目前,尚缺乏大样本临床证据支持生物补片在盆底重建中优于合成补片。BACKGROUND： The biological material is expected to overcome complications of the synthetic mesh for reconstructive pelvic surgery. Heterogeneous biological materials have been widely used in the field of female pelvic floor reconstruction recently due to the wide source. OBJECTIVE： To summarize basic and clinical research progress of biological mesh in the field of female pelvic floor reconstruction in recent years. Clinical efficacy and complications of different biological materials were also reviewed. METHODS： A comprehensive retrieval of CNKI and Pubmed search from January 2000 to August 2010 was undertaken using the Keywords of ＂xenograft, surgical mesh, biomaterial, prolapse, stress urinary incontinence＂ in English and ＂biomaterial; pelvic reconstruction; prolapse; stress urinary incontinence＂ in Chinese. RESULTS AND CONCLUSION： A total of 177 literatures were collected, and 35 articles were included. The histological reaction of biological mesh was mainly determined by the pore size and the chemical cross-linking structure. Clinical efficacy and complications of different biological materials showed significant differences due to difference in properties, surgical approaches, grouping criteria and follow-up standards. Patients’ age and history of previous pelvic surgeries were the two main factors that affected success rate of reconstruction surgery. Currently, large-sample clinical evidence are not available to support that biological mesh is better than synthetic mesh in pelvic floor reconstruction.

关 键 词：生物材料 盆底重建 子宫脱垂 压力性尿失禁 胶原 小肠黏膜 

分 类 号：R318[医药卫生—生物医学工程]